Objectives-To estimate the incidence of adult Still's disease (ASD) and to specify, if possible, associated factors. Methods-A retrospective study of the populations of the Brittany and Loire regions in west France was made from 1 January 1982 to 31 December 1991. All internal medicine and rheumatology practitioners of these regions were consulted. Results-Sixty-two (62) cases were reported (93% response). The disease incidence calculated over five years was 0-16 per 100 000 inhabitants in the study population. There was no sex bias (sex ratio 1-06 in ASD v 1-05 in the overall population. The mean age of the study population was 36 years, with two peaks of distribution at 15-25 and 36-45 years.
IgG subclasses of anti-double-stranded DNA antibodies were determined in 182 patients with systemic lupus erythematosus. All isotypes were detected, but IgG1 and IgG3 were predominant (62 and 51% of the cases, respectively). An average of 64 ± 27% was IgG1, 16 ± 22% IgG2, 16 ± 19% IgG3 and 4 ± 10% IgG4. The rank order or frequency was IgG1, IgG3, IgG2 and IgG4 in patients with musculoskeletal involvement; IgG1, IgG2, IgG3 and IgG4 in those with renal complications; IgG3, IgG1, IgG2 and IgG4 in those with cutaneous involvement; and IgG1, IgG3, IgG2 and IgG4 in those with hematological manifestations. Interleukin-4 (IL-4) was dectectable in 17 of 36 selected patients, as opposed to 1 of 40 normal controls. The percentage of the total autoantibody contributed by IgG1 was significantly higher (p <0.03) in these patients than in the remainder with undetectable levels of IL-4.
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